Abstract:
PURPOSE:Uterine rupture during labor is a rare but life-threatening complication after previous cesarean section (CS). Prenatal risk is assessed using ultrasound thickness measurement of the lower uterine segment (LUS). Due to inhomogeneous study results, however, clinical obstetrics still lacks for standard protocols and reliable reference values. As 3 T magnetic resonance imaging (MRI) has not yet been sufficiently studied regarding LUS diagnostics after previous CS, we sought to evaluate its feasibility focusing on thickness measurements and typical characteristics of the CS-scar region in comparison to ultrasound and the intraoperative status. METHODS:In this prospective study, 25 asymptomatic patients with one previous CS and inconspicuous ultrasound findings were included. An additional 3 T MRI with either a T2-weighted Turbo-Spin-Echo or a Half Fourier-Acquired-Single-shot-Turbo-spin-Echo sequence in a sagittal orientation was performed. We analyzed categorical image quality, inter- and intra-rater reliability as well as anatomy, morphology and thickness of the LUS. Results were compared to ultrasound and intraoperative findings. RESULTS:MRI provided good to excellent image quality in all patients. The imaged structures presented with a high variability in anatomy and morphology. Image characteristics indicating the uterine scar were only found in 11/25 (44%) patients. LUS thickness measurements with MRI showed good inter- and intra-rater reliability but poor agreement with ultrasound. CONCLUSIONS:MRI is appropriate for additional LUS diagnostics in patients with previous CS. The strong individual variability of LUS-anatomy and morphology might explain the difficulties in establishing uniform diagnostic standards after CS.
journal_name
Arch Gynecol Obstetjournal_title
Archives of gynecology and obstetricsauthors
Hoffmann J,Exner M,Bremicker K,Grothoff M,Stumpp P,Schrey-Petersen S,Stepan Hdoi
10.1007/s00404-018-4988-xsubject
Has Abstractpub_date
2019-02-01 00:00:00pages
439-449issue
2eissn
0932-0067issn
1432-0711pii
10.1007/s00404-018-4988-xjournal_volume
299pub_type
杂志文章abstract:BACKGROUND:Many studies have shown that changes in the weather affect health. In the field of obstetrics and gynecology, several events have been empirically shown to be related to the weather. Labor pain is controlled by the autonomic nervous system and various hormones, and is expected to be influenced by the weather...
journal_title:Archives of gynecology and obstetrics
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pub_type: 杂志文章,随机对照试验
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更新日期:2014-03-01 00:00:00
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pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2015-06-01 00:00:00